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1790234151
RICHARD J VANWAGONER
JACKSON, MI
NPI
1790234151
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: MI 6802020984)
Enumeration Date
2016-09-27
Last Update Date
2016-09-27
Business Address
Mr. RICHARD J VANWAGONER LBSW
216 W MORRELL ST STE 300
JACKSON, MI 49203-2351
Phone number: 517-782-0380
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Mailing Address
Mr. RICHARD J VANWAGONER LBSW
3366 REYNOLDS RD
JACKSON, MI 49201-9398
Phone number: 517-240-4778
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